• Oznur Bal, Berna Oksuzoglu, Mutlu Dogan, Ayse Durnali, Ummugul Uyeturk, Ayse Demirci, Ulku Yalcıntas Arslan, Ahmet Siyar Ekinci, Nuriye Yildirim, Necati Alkis, and Selim Kilic.
• Department of Medical Oncology, Ankara Numune Training and Research Hospital, 06200, Ankara, Turkey.
• Ir J Med Sci. 2020 Aug 1; 189 (3): 805-810.

BackgroundBisphosphonates are the mainstay therapeutic options for prevention of skeletal-related events and generally used for up to 2 years in bone metastatic cancer patients.AimWe aimed to evaluate the long-term outcomes of prolonged (> 2 years) bisphosphonate usage in bone metastatic breast cancer (BMBC) patients.MethodsNinety-nine BMBC patients who had prolonged bisphosphonates were evaluated retrospectively for long-term outcomes and survival rates.ResultsMedian duration of bisphosphonate therapy was 46.8 (24-198) months. Seven patients had bisphosphonate-related adverse events (osteonecrosis of the jaw (ONJ) (n = 6), ONJ and renal failure (n = 1)). Bisphosphonate was switched to another one because of bone metastasis progression in more than one-third of the patients (n = 36, 36.3%). The patients who had bisphosphonate switch therapy had statistically significant longer overall survival (p < 0.01). Neither duration nor type of bisphosphonates had effect on frequency of bisphosphonate-related adverse events.ConclusionBisphosphonates might be prolonged for more than 2 years in BMBC patients with an acceptable toxicity profile. In addition, bisphosphonates switch therapy should be preferred in those with progressive bone metastasis since it might contribute to better survival despite bisphosphonates could not have been shown to have survival benefit in previous studies.

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